The Worst Fear
When my daughter was a newborn and COVID-19 was brand new, my worst fear was that she would catch it and end up in the hospital because of severe illness, and that my husband and I wouldn’t be able to be with her because of visitor limitations. We didn’t know what the level of risk was, or how it affected infants and young children at the time. Last week, I had to face that fear – but it wasn’t COVID that put us there. It was a far more common and well-known virus.
Last week, we kept our daughter home from daycare on Monday because she had been coughing all night and we noticed she was using her abdominal muscles to breathe. At this point, we assumed it was allergies – her eyes had been red and watery, tree pollen was high, and both my husband and I have season allergies that had been acting up. We made an appointment with her pediatrician for the afternoon and assumed we’d be home within an hour or so.
By the time we got to the pediatrician, she was still breathing with her stomach muscles, we had noticed that the muscles in her neck wore working hard, and my husband had counted 55 breaths per minute (normal for toddlers is 24-40 breaths per minute). The nurse took her temperature and got 101.7, and I felt vindicated because I knew she had felt warm at home but I couldn’t get our home thermometer to get any reading higher than 98.7. We expressed concern about her breathing, and he took an oxygen reading and calculated her respiratory rate, and left to get the pediatrician.
At this point, we now knew she was fighting something off because she was running a fever, but we just didn’t know what. To our knowledge, we hadn’t been around anyone who had COVID or the flu. What was making her so sick and causing her to work so hard to breathe?
After examining her, the pediatrician (who was actually the doctor we saw last summer when she had RSV), suggested we give her a breathing treatment at the office with a nebulizer and albuterol and see if she responded to that. She was also swabbed for COVID and flu.
Like any toddler, my daughter hates the nebulizer. We had to use it 3 times a day last summer when she had RSV. My husband had to hold her in place and I would hold the mask up to her face, urging her to watch whatever Disney movie was on and reassuring her that we were almost done and she was doing so well, all while she writhed and screamed and tried to get her face away from the mask. She did the same thing here, and faked us out a little – the nurse left us with the nebulizer because she seemed like she was doing so well with it, only for her to start throwing an epic tantrum once the door was shut.
After the first treatment and she calmed down a little, we checked her respiratory rate and oxygen levels again. Her breaths per minute had dropped down to 44, but her oxygen was still hanging in the high 80s and low 90s. Another treatment was ordered, and this time my daughter was so exhausted from being up all night coughing and fighting one breathing treatment that she fell asleep leaning against my chest as the nurse held the nebulizer up to her face. It was so unlike her, she hasn’t fallen asleep on me since before her first birthday, and during a breathing treatment, something she hates and actively fights against…something wasn’t right. My anxiety was starting to creep up, and I could feel it coiled in my stomach like a snake, waiting.
About 20 minutes after the second breathing treatment, the nurse returned to take her oxygen level again. She tried with one pulse oximeter, shook her head and went to go get another one. “Let’s just try all the different options we’ve got,” she said when she returned, clipping it around my daughter’s finger, then the webbing between her thumb and pointer finger, and back to her middle finger.
I couldn’t watch the oximeter readings. I saw it sit at 88 and closed my eyes, tilting my head back towards the ceiling, unable to bring myself to watch it, trying hard to stop the tears that were slipping out of my eyes and down my cheeks into my mask. This wasn’t good, not at all.
My daughter’s oxygen reading at that time was borderline, at 93-94. She was still using her abdominal muscles to breathe, we could see her collarbones with each breath, and her nostrils were flaring. The pediatrician wasn’t comfortable sending us home with the way she was breathing, so she told us to head for the ER. She was going to call ahead and let them know where were on our way, but she couldn’t make the call that it was okay for us to go home. We still didn’t know what had gotten us to this point; my daughter had tested negative for both COVID and flu.
I tried to check out at the counter, tried to explain we needed to make a follow-up appointment for the next morning in case we didn’t have to stay at the hospital, but my tongue felt heavy in my mouth and my brain didn’t want to work. There was a roaring in my ears as I held my sick baby and tried not to cry.
My husband took care of updating our parents (mine were on vacation in Dallas) and siblings on where we were headed and what was happening. I sat in the front seat of the car and tried to calm myself down, it felt like time was speeding up and slowing down; I wanted my husband to put his foot on the gas and fly down the interstate.
When we got to the hospital, it was like I had tunnel vision. I was out of the car before my husband had even turned it off, had her door open and fumbled with the car seat buckle. My only focus was getting her inside the hospital doors and to someone who could make her feel better, could help her breathe, could do anything to fix this and make my baby well.
When the automatic doors opened to the ER waiting room, my heart sank. It was full. We stood in line as I felt her stomach and chest moving against me, as I wanted to scream at everyone to move out of the way because couldn’t they see my baby was having trouble breathing?
When we got to the counter, my husband had to do most of the talking and explaining. It felt like I couldn’t hear anything, whether that was because of the masks or the roaring in my ears since I was in full fight-or-flight mode, I don’t know. It felt like my brain just wasn’t working, and I couldn’t focus on anything but my daughter.
One of the perks of being a pediatric emergency patient and that your pediatrician called ahead is that you get to skip the line. They took us back to get her temperature and oxygen levels again (we were up to a 102 fever by now), and then we were immediately whisked back into the ER. A large triage room was set up and 2 nurses, 2 physicians assistants, and a pediatric respiratory therapist were waiting for us.
They immediately had me sit on the bed with my daughter on my lap, and they removed her shoe and sock and wrapped a pulse oximeter around her big toe. In a moment that will forever live in my mind as the moment I knew she was highly sensitive, she kept sticking her foot at my husband and saying “Help! Help!” She wanted that off her toe, and it reminded me of how I had to have the pulse oximeter on my toe when I was in labor with her, and how it also bugged me.
She was swabbed for RSV and a chest X-ray was ordered. When the x-ray technician came in with a portable machine, I had to put on the heavy apron and hold her arms up and push her back against the plate in the bed while she cried as the x-rays were taken. A third breathing treatment was administered by the pediatric respiratory therapist, some Tylenol was administered, and we were left alone for her to calm down. After everything she had been through that day and as the Tylenol kicked in and brought down her fever, she started to cuddle into me. My husband got her to fall asleep again on my chest by gently rubbing her head and back, and as her eyes closed, he promised he’d be right here with her when she woke up.
As she was sleeping, we were visited by one of the ER physicians and then one of the doctors from the pediatrics department. Our girl had tested positive for RSV, and we were going to be admitted overnight for monitoring because her oxygen levels were still hanging around in the low 90s, occasionally dipping into the high 80s as she slept. We were escorted to the pediatrics unit by the respiratory therapist and checked into a room. The nurse was incredibly kind and sweet, and a little animal pillow was waiting on the crib mattress. It was a pink cat, which delighted my daughter, who immediately proclaimed it a “pink KeeCat” and started meowing.
Her good mood evaporated when cardiac monitors had to be applied to her chest and the pulse oximeter was hooked back up to the equipment in the room. The whole time she had been beyond opposed to her shirt being lifted so that the nurses or doctors could watch her breathing, so having to have her shirt lifted again to apply the monitors set her off. Once we finally got her calm again, she settled into the recliner with me next to the crib (she couldn’t go very far, being hooked up to everything), and got her to watch Paw Patrol (have you ever tried to explain what a commercial is or why you can’t just make Baby Shark appear on the TV to a toddler who has only had streaming services?).
After dinner (a well-deserved Happy Meal with nuggets and French fries, two of her favorite things, because after that horrible day she deserved something yummy), we got her ready for bed and prepared for a final breathing treatment of the day. The doctors and nurses let us know that she may need oxygen overnight since she would likely desaturate as she slept, and when we were finally finished with vitals checks and the breathing treatment, she went right into the crib. My husband and I were shocked – we expected a fight and a screaming match to ensue, because it wasn’t her bed. She was so exhausted and didn’t feel well that she just wanted to lay down and sleep.
My husband and I tried to relax and get comfortable in the recliner and on the couch, I tried to read and he tried to play on his Switch, but we were both hyper alert to our daughter in the crib, the high bars all the way up around her. Every now and then she’d whimper for Mommy or Daddy, and we’d rush over and tell her we were right here, and we’d be right here with her all night long.
Around 10:00, we heard the door creak open and two nurses entered to let us know that our daughter’s oxygen was sitting around 85, and she would need to be put on oxygen. They lowered the crib bars and my husband and I watched as they put the adhesive stickers to hold the tubing in place on her cheeks and as they placed the cannula in her nose and slipped the tubing behind her head. She cried out for us, not knowing what was going on, tried to pull the cannula out, and reached out her hands and cried “Mommy!”
And I broke.
I had to cover my mouth and try not to let loose a scream, tried to keep back the sobs that felt as if they would break me in half. There was my baby, hooked up to monitors, an oxygen cannula in her nose, reaching and crying for me, and I couldn’t even get her out because the tubing for the cannula was so short. All the fear, all the exhaustion, all the anxiety rose up in me and I felt as if I could shatter from it all. I wanted to drop to my knees and wail, but I couldn’t. I sobbed into my husband’s chest after he calmed our daughter down and got her back to sleep, and he urged me to go read, go to sleep, do anything to keep my mind off what was happening in front of me.
Somehow, we made it through the night. I’m not sure if any of us really got any sleep, between the nurses checking on her, the general discomfort of hospital furniture, and our own hyper-attentiveness as parents (I don’t think I’ve ever moved so fast in my life as when, around 4:00 am, my daughter cried out for me in her sleep and I flew across the room to the crib to comfort her). Around 8:00 the next morning, the nurses let us know that they were able to turn off the oxygen at 3:30, and she slept without it the rest of the night.
We were finally released to go home about an hour later, and as soon as she was unhooked from the monitors, my daughter started running around the room, so happy to be untethered and free to go wherever she wanted. I had to head out into the lobby to call our pediatrician and make a follow-up appointment for later in the week, and when I came back into the room and she ran to me, squealing “Mommy! Mommy!” with the biggest smile on her face. I cried again, but it was happy tears that time.
In the week since, she’s continued to improve and is acting like herself again, although she may have developed an ear infection. You can’t even tell that a week ago, she was having trouble breathing and needed to be admitted to the hospital for overnight monitoring.
I have had a bit of a harder time. I nearly slept on her floor that first night we were home because I was scared she’d start having trouble breathing again and we wouldn’t know because we’d be down the hall in our room, but managed to talk myself out of it (mostly because I didn’t want to aggravate a low back injury from a car wreck a year ago). We kept her home from daycare again the next day, because I didn’t want her out of my sight. I wanted eyes on her at all times, so that I could tell if she was having trouble breathing again. I tried to tell myself that the doctors had told us a little belly breathing was normal as she recovered, and that compared to how she had been, it wasn’t anything like that Monday when we took her to the pediatrician. I couldn’t get the image of her, hooked up to the monitors and oxygen on, reaching for me from the crib, out of my mind. I kept replaying when we walked into the ER triage room where we were first treated and saw 5 different people waiting for us. I wasn’t sleeping well, and food didn’t taste good, if it had a taste at all.
I’ve experienced enough mental health complications and been in therapy long enough to know that I was experiencing some trauma responses (flashbacks), anxiety (hypervigilance and constant worry), and depression (numb, appetite disturbances, lack of interest in, well, anything). After a therapy session using EMDR (Eye Movement Desensitization and Reprocessing), I’ve been able to start feeling better. My husband has mentioned that I sound like myself again, and I’m no longer feeling numb and have found joy in things again.
We’re getting back to normal. My husband and I have been back at work, digging ourselves out from the pile of unanswered emails and backlogged projects from the last week, and our daughter is back at daycare, coloring and painting and dancing and playing with her friends. I will likely need another intensive therapy session on what we went through, because there are still times where I catch myself watching her monitor after we put her to bed, checking to see if she’s breathing normally.
That Monday was absolutely one of the hardest, scariest days of my life. I have never felt as frightened or as helpless as that day, when my baby was struggling to breathe and I couldn’t do anything but wait and let the experts do their jobs. I wanted so desperately to make her well and there was nothing I could do but hold her and promise her that everything would be okay.
We are so very thankful for the pediatrician we saw who trusted her gut and sent us to the ER instead of sending us home, to the nurses and doctors and respiratory therapists who took care of us at the ER and in the pediatrics unit of the hospital, and our friends and family and those of you who follow me on social media who thought about us, prayed for us, and sent us love. We felt it and we appreciate it more than you could ever know.
I’m very much looking forward to when my daughter is old enough that RSV is just a cold for her and not something that sends us to the ER and the hospital. I’m still working on being gentle with myself, and letting myself feel everything from the last week. It’s not easy. But it is worth it.
RSV is common, but it can be severe in infants and young toddlers. The American Academy of Pediatrics has an article about what to watch for, such as fast breathing, flaring of the nostrils, head bobbing with breathing, rhythmic grunting when breathing, belly breathing, tugging beneath the ribs, and/or tugging at the lower neck, and wheezing. Please be on the look out for these symptoms if you have young kids, especially since RSV is now appearing in the summer and not just its typical fall/winter season. Disclaimer: I am not a doctor or pediatrician, and you should consult your doctor and/or pediatrician if you have concerns.